WO2005110273B1 - Method and apparatus for treating pelvic organ prolapse - Google Patents

Method and apparatus for treating pelvic organ prolapse

Info

Publication number
WO2005110273B1
WO2005110273B1 PCT/US2005/012805 US2005012805W WO2005110273B1 WO 2005110273 B1 WO2005110273 B1 WO 2005110273B1 US 2005012805 W US2005012805 W US 2005012805W WO 2005110273 B1 WO2005110273 B1 WO 2005110273B1
Authority
WO
WIPO (PCT)
Prior art keywords
support member
organ
end portions
support portion
region
Prior art date
Application number
PCT/US2005/012805
Other languages
French (fr)
Other versions
WO2005110273A1 (en
Inventor
James E Cox
Kimberly A Anderson
Robert E Lund
Brian P Watschke
Original Assignee
Ams Res Corp
James E Cox
Kimberly A Anderson
Robert E Lund
Brian P Watschke
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ams Res Corp, James E Cox, Kimberly A Anderson, Robert E Lund, Brian P Watschke filed Critical Ams Res Corp
Priority to CA002577839A priority Critical patent/CA2577839A1/en
Priority to EP05738692A priority patent/EP1744701B1/en
Priority to AU2005244191A priority patent/AU2005244191B2/en
Priority to DE602005023851T priority patent/DE602005023851D1/en
Publication of WO2005110273A1 publication Critical patent/WO2005110273A1/en
Publication of WO2005110273B1 publication Critical patent/WO2005110273B1/en
Priority to AU2009206178A priority patent/AU2009206178B2/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B17/06109—Big needles, either gripped by hand or connectable to a handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036—Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045—Support slings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00805—Treatment of female stress urinary incontinence

Abstract

A method of treating pelvic organ prolapse is provided. The method generally includes the steps of establishing a first pathway between the external perirectal region of the patient to the region of the ischial spine in tissue on one side of the prolapsed organ, followed by establishing a second pathway in tissue on the contralateral side of the prolapsed organ. A support member, which includes a central support portion (2) and two end portions (32), is positioned in a position to reposition said prolapsed organ in said organ’s anatomically correct location. The end portions of the support member are introduced through the respective tissue pathways, followed by adjustment of the end portions so that the support member is located in a therapeutic relationship to the prolapsed organ that is to be supported. An apparatus and kit for said treatment is further provided.

Claims

AMENDED CLAIMS
[Received by the International Bureau on 24 November 2005 (24.11.2005 ): original claims 1-27 replaced by amended claims 1-29]
CLAIMS:
1. A method for repair of pelvic organ prolapse in a patient, said method comprising the steps of: establishing a first pathway in tissue on a first side of said prolapsed organ, said pathway extending between an external perirectal region to a region of an ischial spine of the patient; establishing a second pathway in tissue on a contralateral side of said prolapsed organ, said pathway extending between an external perirectal region to a region of an ischial spine of the patient; positioning a support member in a position to reposition said prolapsed organ in said organ's anatomically correct location, said supporting member comprising a support portion having a first and second end, and two end portions, said end portions respectively attached to said first end and said second end; introducing said end portions through said first and second pathways, respectively; and adjusting said end portions so that said support member is in a therapeutic relationship to a tissue of said prolapsed organ that is to be supported.
2. The method of claim 1 , wherein said pelvic organ prolapse is a vaginal vault prolapse.
3. The method of claim 1 , wherein said pelvic organ prolapse is an enterocele.
4. The method of claim 1 , wherein said pelvic organ prolapse is a rectocele.
24 5. The method of claim 1 , wherein said pelvic organ prolapse includes more than one of the group consisting of vaginal vault prolapse, enterocele, and rectocele.
6. The method of claim 2, wherein the step of establishing a first pathway in tissue on a first side of said prolapsed organ, said pathway extending between an external perirectal region to a region of an ischial spine space of the patient, comprises the steps of: making a midline incision in an apex of a vagina; dissecting to a region of an ischial spine; making a first incision lateral and posterior to the rectum in a skin of a buttocks; passing a needle from said first incision toward said vaginal incision; palpating a tip of said needle distal and inferior to an ischial spine; and passing said needle through a coccygeous muscle.
7. The method of claim 2 wherein the step of establishing a second pathway in tissue on a contralateral side of said prolapsed organ, said pathway extending between an external perirectal region to a region of an ischial spine of the patient, comprises the steps of: making a second incision lateral and posterior to the rectum in a skin of a buttocks on the contralateral side respective to said first incision; passing a needle from said second incision toward said vaginal incision; palpating a tip of said needle distal and inferior to an ischial spine; and passing said needle through a coccygeous muscle. 8. The method of claim 2 wherein said step of poϋ ilioniug a support member in a position to reposition said prolapsed organ in said, organ's anatomically correct location, said supporting member comprising a iupport portion having a first and second end, and two end portions, said end pon ions respectively attached to said first end and said second end, comprises the step1 of connecting said support member to a tip a needle, said needle being pas fed from an incision in said patient's external perirectal region through a tis iue on a side of said prolapsed organ through to said region of an iscliial spine of the patient to form said pathway.
9. The method of claim 2, wherein said step of int "pducing said end portions through said first and second pathways comprises the st ϊp of retracting back through said respective pathways a needle to which said end portions have been connected.
10. The method of claim 2, wherein said step of adjusting said end portions so that said support member is in a therapeutic relation ship to a tissue of said prolapsed organ that is to be supported further comprises: attaching said support member to a vagii iial wall with sutures; ensuring a vaginal vault is in an appropr ate anatomical position; and adjusting said support member by maπij tlation of said end portions.
11. An elongated substantially support member ext tiding between first and second support member ends for treating pelvic organ pitolapse in a patient comprising: a support portion intermediate said first ihd second support member ends for placement in a therapeutically effective posi ion ,, the support portion having opposed first and second support portion ends j< ined by first and second support portion sides; a first elongated end portion connected t<t»i said first end of said support portion between the first and second support poϊt iϊoon: sides and having first and second end portion sides and extending to the fi st support member end; and
26
Figure imgf000005_0001
rectangular, having a first and second relatively (long ends and first and second relatively short sides.
27 16. The support member of claim 11 , wherein: said support portion comprises abiolog ώ graft sheet having first and second sides and ends; and means for coupling ends of the first and second elongated end portions to respective first and second ends of said support portion between the first and second support portion sides.
17. The support member of claim 115 wherein said support portion is made from a polypropylene monofilament mesh,
IS. The support member of claim 11, wherein said support portion is made from a knitted surgical mesh comprised of a knitted yajii having a thickness of about .021 inches, having about 27.5 courses per inch, and about 13 wales per inch three bar warp knit construction with a bar pattern set-up <t>f #l: 1/0, 2/3, 2/1, 2/3, 1/0, 1/2, 1/0, 1/2: #2:1/0, 2/3, 2/3, 1/0: #3: 2/3, 1/0, 1/2, /0, 2/3, 2/1, 2/3, 2/1.
19 The support member of claim 1 1, wherein at le. st one of said end portions is made from a polypropylene monofilament mesl
20. The support member of claim 11, wherein at lesjit one of said end portions is made from a knitted surgical mesh comprised o a knitted yarn having a thickness of about .021 inches, having about 27.5 courses per inch, and about 13 wales per inch three bar warp knit construction with a bar pattern set-up of #1 : 1/0, 2/3, 2/1 , 2/3, 1/0, 1/2, 1/0, 1/2: #2:1/0, 2/3, 2/3, 1/0: #3: n, 1/0, 1/2, 1/0, 2/3, 2/1 , 2/3, 2/1.
21. The support member of claim 11 , wherein said md portions and said support portion are formed from differing mesh knits.
22. The support member of claim 11 , wherein said mά portions and said support portion arc formed from differing materials.
28
Figure imgf000007_0001
29 28.
Figure imgf000008_0001
30 29.
Figure imgf000009_0001
31
PCT/US2005/012805 2004-04-30 2005-04-14 Method and apparatus for treating pelvic organ prolapse WO2005110273A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CA002577839A CA2577839A1 (en) 2004-04-30 2005-04-14 Method and apparatus for treating pelvic organ prolapse
EP05738692A EP1744701B1 (en) 2004-04-30 2005-04-14 Apparatus for treating pelvic organ prolapse
AU2005244191A AU2005244191B2 (en) 2004-04-30 2005-04-14 Method and apparatus for treating pelvic organ prolapse
DE602005023851T DE602005023851D1 (en) 2004-04-30 2005-04-14 DEVICE FOR TREATING THE INCIDENT OF A BODY ORGAN
AU2009206178A AU2009206178B2 (en) 2004-04-30 2009-08-06 Method for treating pelvic organ prolapse

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/834,943 US7500945B2 (en) 2004-04-30 2004-04-30 Method and apparatus for treating pelvic organ prolapse
US10/834,943 2004-04-30

Publications (2)

Publication Number Publication Date
WO2005110273A1 WO2005110273A1 (en) 2005-11-24
WO2005110273B1 true WO2005110273B1 (en) 2006-01-26

Family

ID=34966869

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2005/012805 WO2005110273A1 (en) 2004-04-30 2005-04-14 Method and apparatus for treating pelvic organ prolapse

Country Status (6)

Country Link
US (2) US7500945B2 (en)
EP (1) EP1744701B1 (en)
AU (2) AU2005244191B2 (en)
CA (1) CA2577839A1 (en)
DE (1) DE602005023851D1 (en)
WO (1) WO2005110273A1 (en)

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EP1744701B1 (en) 2010-09-29
AU2009206178B2 (en) 2011-04-14
US8211005B2 (en) 2012-07-03
AU2005244191B2 (en) 2009-08-13
US20050245787A1 (en) 2005-11-03
US7500945B2 (en) 2009-03-10
WO2005110273A1 (en) 2005-11-24
US20090137864A1 (en) 2009-05-28
EP1744701A1 (en) 2007-01-24
AU2009206178A1 (en) 2009-08-27
CA2577839A1 (en) 2005-11-24
DE602005023851D1 (en) 2010-11-11
AU2005244191A1 (en) 2005-11-24

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